Marine Stings and Scrapes

Topic Contents

Marine Stings and Scrapes

Topic Overview

Walking on a beach or swimming in the ocean can
be fun and relaxing. But just like any other activities, accidents can happen.
This topic will help you determine the next steps to take if you have a
jellyfish or Portuguese man-of-war sting, seabather's eruption, or a coral
scrape.

Stings

Jellyfish and Portuguese man-of-wars are
members of a large group of venomous marine animals that also includes fire
coral and sea anemones. They are present all over the world and cause injury
and illness through the release of venom when their
tentacles come in contact with skin (stinging). Tentacles are long, slender, flexible growths found on jellyfish,
Portuguese man-of-wars, squid, and octopuses. Tentacles are used for grasping,
feeling, moving, and killing prey by stinging. While
the sting of a jellyfish or Portuguese man-of-war can cause severe illness and
extreme pain, documented deaths are rare.

Jellyfish are often
present in coastal waters, having been brought ashore by winds or ocean
currents. They are most common in warm ocean waters, especially along the
Atlantic coast of the United States. Stings result from contact with the
tentacles, which trail from the jellyfish's see-through body. Jellyfish
swimming in the water are often hard to see. Beached jellyfish, which may look
like the cellophane wrapper from a cigarette pack, can sting if touched.

Jellyfish stings cause immediate, intense pain and burning that can last
for several hours. Raised, red welts develop along the site of the sting, which
may look like you have been hit with a whip. The welts may last for 1 to 2
weeks, and
itchy skin rashes may appear 1 to 4 weeks after the sting.
Fortunately, most jellyfish stings are not severe. Extensive stings,
allergic reactions, or
severe reactions are not common but do occur. To
avoid the risk of drowning, swimmers should get out of the water as soon as
they realize they have been stung.

The box jellyfish, which is
found in the Indian Ocean and South Pacific, can cause a fatal reaction. It is
the only jellyfish for which a specific antidote (antivenin) exists.
If you get this antivenin, it may save your life.

Seabather's eruption is a rash that develops from the stings of jellyfish or sea
anemone larvae. The rash can be quite itchy and annoying, but it usually goes away
without medical treatment in 10 to 14 days.

Portuguese man-of-wars
(hydrozoans) live in warm seas throughout the world but are most common in the
tropical and subtropical regions of the Pacific and Indian oceans and in the
Gulf Stream of the North Atlantic Ocean. They float on the surface of the water
with their long, stinging tentacles trailing in the water below. Detached
tentacles that wash up on the beach may remain dangerous for months.

Portuguese man-of-war stings produce immediate burning pain and redness
where the tentacles touched the skin. The affected area develops a red line
with small white lesions. In severe cases, blisters and welts that look like a
string of beads may appear. Stings that involve the eye may cause pain,
swelling, excessive tears, blurred vision, or increased sensitivity to light.
Severe reactions are most likely to occur in children and small adults. Severe
toxic reactions to the venom can also occur.

Stingrays are members of the shark family. They have sharp spines in their tails that can cause cuts or puncture wounds. The spines also have venom. Stingrays do not bite but can suck with their mouths and leave a bruise.

Coral scrapes

Coral scrapes and cuts are common
injuries that may occur when you walk on a beach or swim, snorkel, or dive in
warm water. Coral polyps, the soft living material that covers the surface of
coral, can be easily torn away from the rigid and abrasive structure underneath
if you touch, bump, or fall on coral. A
skin infection may develop when small pieces of coral,
other debris, and bacteria get inside the wound. Scrapes and cuts from
sharp-edged coral may take weeks or even months to heal.

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

Your age. Babies and older
adults tend to get sicker quicker.

Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.

Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.

Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.

Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.

Symptoms of difficulty breathing can range from mild to severe. For example:

You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).

It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Symptoms of a severe allergic reaction
(anaphylaxis) may include:

The sudden appearance of raised, red areas (hives)
all over the body.

Rapid swelling of the throat, mouth, or tongue.

Trouble
breathing.

A severe reaction can be life-threatening. If you have had a
bad allergic reaction to a substance before and are exposed to it again, treat
any symptoms as an emergency. Even if the symptoms are mild at first, they may
quickly become very severe.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.

Long-term alcohol and drug
problems.

Steroid medicines, which may be used to treat a variety
of conditions.

Chemotherapy and radiation therapy for
cancer.

Other medicines used to treat autoimmune
disease.

Medicines taken after organ transplant.

Not
having a spleen.

Pain in adults and older children

Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.

Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.

Make an Appointment

Based on your answers, the problem may not improve without medical
care.

Make an appointment to see your doctor in the
next 1 to 2 weeks.

If appropriate, try home treatment while you
are waiting for the appointment.

If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.

Home Treatment

Home treatment can help ease your
discomfort and prevent other problems.

Jellyfish and Portuguese man-of-war stings

Do not rub the
tentacles with your hands, a towel, sand, or
clothing.

Use hot water on the area to help remove the nematocysts, the stinging part of the tentacle. If available, topical lidocaine can be applied to the sting area.

If hot water and lidocaine are not available, remove the nematocysts and wash the area with salt water.

For some types of jellyfish stings, a compress of household vinegar (5% acetic acid
solution) and hot water can be used on the affected area to prevent further
stings.

Do not use urine, gasoline, kerosene, or
turpentine.

Rinse eye stings with a saline solution, such as
Artificial Tears. Do not put vinegar, alcohol, or any other "stinger solution"
in the eyes. The skin around the eye can be dabbed with a cloth soaked in
vinegar, but you must be extremely careful not to get any of the solution in
the eye.

After decontamination, pick off tentacles with a stick or
your hand protected by a towel or glove. Be very careful not to rub or press
the tentacles.

If it is available, apply a lather of shaving cream
or soap, or a paste of baking soda, flour, or talc to the skin. The stinging
cells will stick to the shaving cream or paste and can then be easily scraped
off with a safety razor, a knife edge, or the edge of a credit
card.

Take an
antihistamine , such as diphenhydramine or
chlorpheniramine, or apply
1% hydrocortisone cream to help control itching.
Note: Do not use the cream on children younger than age
2 unless your doctor tells you to. Do not use in the rectal or vaginal area in
children younger than age 12 unless your doctor tells you to. Also, don't give
antihistamines to your child unless you've checked with the doctor first.

Shower
with fresh water. Apply soap and vigorously scrub your skin. Do not shower with
a contaminated suit on. If larvae are trapped in the fabric of a suit, a
freshwater shower will cause the larvae to sting.

Take an
antihistamine , such as diphenhydramine or
chlorpheniramine, or apply
1% hydrocortisone cream cream to help control itching. Note: Do not use the cream on children younger than age 2
unless your doctor tells you to. Do not use in the rectal or vaginal area in
children younger than age 12 unless your doctor tells you to. Also, don't give
antihistamines to your child unless you've checked with the doctor first.

Coral scrapes and cuts

Most minor coral scrapes or
cuts can be treated at home.

Wash the wound for 5 minutes with a soft brush
or towel and large amounts of warm water and soap (mild dishwashing soap, such
as Ivory, works well). Cleaning the wound as soon as possible may reduce the
risk of infection, scarring, and tattooing of the skin from coral material left
in the wound.

After washing, rinse the wound with a
large amount of fresh water.

After rinsing with fresh water, rinse
the wound again with a solution of one-half hydrogen peroxide and one-half
water.

After rinsing with a solution of one-half hydrogen peroxide
and one-half water, rinse again with fresh water.

Use an antibiotic ointment, such as
polymyxin B sulfate (for example, Polysporin) or bacitracin. Put the ointment
lightly on the wound. The ointment will keep a bandage from sticking to the
wound. Be sure to read the product label about skin sensitivity. If a skin rash
or itching under the bandage develops, stop using the ointment. The rash may
mean you had an allergic reaction to the ointment. Antibiotic ointments that
contain neomycin may have an increased risk of causing an allergic reaction.

Consider bandaging the wound. You may need to protect your wound
from getting dirty or irritated. If available, use a nonstick dressing. Be sure
to read the product label for correct use.

Clean the wound thoroughly before bandaging
it to reduce the risk of infection occurring under the
bandage.

Apply a clean bandage when it gets wet or soiled to
further help prevent infection.

If a bandage is stuck to a scab,
soak it in warm water to soften the scab and make the bandage easier to
remove.

Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin

Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow these
safety tips when you use a nonprescription medicine:

Carefully read and follow all directions
on the medicine bottle and box.

Prevention

You can limit your risk of being injured
by jellyfish, a Portuguese man-of-war, or coral.

Be familiar with the marine risks in the
area where you plan to swim, snorkel, or dive. If you are traveling, obtain
information about the local conditions.

Be prepared with first aid
supplies that might be needed for a injury.

Watch for warning signs
that are posted when there is a jellyfish or Portuguese man-of-war
invasion.

Do not touch jellyfish, Portuguese man-of-wars, or
coral.

Watch out for jellyfish and Portuguese man-of-wars in the
water, particularly when there are strong onshore winds.

Stay out
of the water when jellyfish and Portuguese man-of-wars are present. Look out
for the bluish floats of the Portuguese man-of-war, and avoid the poisonous
trailing
tentacles.

Watch for beached jellyfish and
Portuguese man-of-wars. Their tentacles may still sting.

Do not
rely on clothing or on coating the skin with petroleum jelly (such as Vaseline)
to prevent stings. Wear a
wet suit to reduce your risk of getting
stung. A wet suit is a close-fitting, one- or two-piece suit, usually made
of rubber or foam neoprene. Swimmers, snorkelers, divers, kayakers, and other
people who spend time in cold water may wear wet suits for warmth and
protection.

Wear protective shoes when walking on the beach. Avoid
stepping on marine life.

Avoid swimming or snorkeling in swallow
water, where touching or bumping into coral might occur.

Wash your
swimsuit with detergent and heat-dry after use. This will kill the stinging
larvae that cause
seabather's eruption .

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the
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